Many Women Worry About Sex After Heart Attack
It's a hidden concern that doctors need to discuss more, experts say
Sex involves emotional and mental well-being, too, Steinbaum noted, and women may have concerns about it even if they feel physically fit. Depression, for instance, is common after a heart attack, and that might affect a woman's sexual functioning.
"We need to address the emotional and psychosocial issues, too," Steinbaum said.
Abramsohn agreed that doctors may not know what to say on the subject, and noted that there are also practical obstacles.
In the immediate term, your doctor is concerned with saving your life, she explained. Then, when you're being discharged from the hospital, the doctor may be focused on your medications or cardiac rehab; any discussion of sexual well-being may get lost.
But it is important for doctors to at least broach the subject, both Abramsohn and Steinbaum said. "If the doctor brings it up," Abramsohn said, "at least the woman will know it's important to them as well, and that she can talk to her doctor about it."
The women in this study had suffered a heart attack an average of two years before the interviews. All but one said they'd started having sex again within six months of the heart attack, but "fear" was common, Abramsohn's team reports.
Some also said their partners were afraid of hurting them.
So what can women do? "Know that you're not alone in having fears surrounding sexual activity," Abramsohn said. "And if you are concerned, bring it up with your doctor."
If you do that but still "feel you're not being heard," Steinbaum said, you can ask for a referral to someone who works with heart patients -- a social worker, psychologist or cardiac rehab nurse, for example.
Cardiac rehab programs, which may be prescribed in the couple of months after a heart attack, involve supervised exercise and counseling on issues like depression and anxiety. A program may not specifically address sexual activity, Steinbaum said, but it may help women feel better, physically and emotionally.
"When you exercise and see that you're getting stronger, you also gain confidence," Steinbaum said.
She added that there may also be specific underlying reasons for sexual dysfunction after a heart attack -- not only depression, but medication side effects or abnormal thyroid hormone activity, for example. That's another reason it's important to talk about sexual issues with your doctor, Steinbaum pointed out.
"If you don't feel like you're getting back to normal after a heart attack," she said, "it's not your fault."